Month: February 2012

This article was written by Mr. Andy Hagler, Director of the Mental Health Association in Forsyth County. He shared this when announcing the upcoming Coalition Town Hall Meetings. (See Events to learn more about these, coming soon to communities in regions of NC.) Andy’s sincere interest in the Dix property is well expressed.

The issue of the future use of the Dorothea Dix campus in Raleigh has advocates concerned state-wide. We hope that many will share their interest in this topic with our lawmakers and Governor Beverly Perdue.

In 1848, Dorothea Dix visited North Carolina. The conditions for the mentally ill that she found in the-then 36 North Carolina counties were much the same as in other states — ranging from extremely poor to above average — with a census of about a thousand persons with mental illness in jails, poorhouses and private homes. Dorothea Dix returned to Raleigh to the General Assembly and called for reform in the care of mentally ill patients. North Carolina and Delaware were the only two of the original 13 Colonies that did not have what were then-called institutions for persons with mental illness. In 1849, when the North Carolina State Medical Society was formed, the construction of an institution in the capital, Raleigh, for the care of mentally ill patients was authorized. The hospital opened in Raleigh in 1856 and was later named in honor of Dorothea Dix. As a native North Carolinian – I grew up hearing people referring to Dorothea Dix Hospital as “Dix Hill” and was typically said, mentioned in a not-so-reverent manner. There is a cemetery on the campus of Dorothea Dix. The first burial took place in 1859. The last burial took place there in 1970.

Why this history lesson? While much has changed in North Carolina and — with the advent of medications and other treatments — in the care and treatment of persons with mental illness since the mid-19th Century – there are some aspects — 150+ years later — in the care and treatment of persons with mental illness that have not changed at all: persons with mental illness are – still today — in our jails, prisons, homeless shelters, hospital emergency rooms. In fact, our jails and prisons — nationwide – have become “the new asylums.”

In addition – not-so-long-ago in the late 20th/early 21st Century – there were special funds in North Carolina called the “Mental Health Trust Fund.” At least in part – some of those funds were used to balance the state’s budget, not necessarily for mental health services. What is left of this trust fund – I don’t know and this is one of those questions where I can never get a straight answer.

Therefore, with the sale of the Dix property – which is state property — in Raleigh, the following should be considered:

FIRST AND FOREMOST: The proceeds of the sale of the property – if this is to take place — are to go into a fund restricted for community-based mental health services, hospital beds, outpatient services and other mental health services and are NOT to be used to balance the budget or as another revenue source to balance the state’s budget. The funds are to be used to benefit ALL citizens of North Carolina with mental health needs.

What is to become of the cemetery? The cemetery on the property – which has 900 graves – should be maintained and treated as hallowed ground. This may be a separate issue or even a “moot” point – but the cemetery represents a time in our history in which people with mental illness were – quite literally – “put away for life.”

A museum should be established on the property so that we do not forget our past. It is important to know the historical components of the treatment of persons with mental illness. The asylums or institutions were a part of the past. As we still do to some degree today – people were separated from the mainstream of society because of mental illness — as well as race. (Find out for yourself and read about the impetus for the establishment of Cherry Hospital in Goldsboro.)

There are buildings and homes on the property which, I believe, are designated as historical sites as they should be preserved as such.

Use the property perhaps as a training center/facility for consumers of mental health services, families, advocates and providers of mental health services that can charge reasonable cost accommodations for lodging, meals, etc.

Use the property as a park for all to enjoy — but do not say this and then – a few years later – sell the land to build a business park, office park or other commercial center. Why should we in Winston-Salem/Forsyth County care? Here is a cut-and-paste from a quote from the website about Dorothea Dix Hospital that should answer this question: In his 1874 hospital report, Superintendent Eugene Grissom wrote: “It was discovered that the insane were not beasts and demons, but men whom disease had left disarmed and wounded in the struggle of life and whom, not unoften, some good Samaritan might lift up, and pour in oil and wine, and set anew on their journey rejoicing.”

What can you do in eight minutes? I can shower in less than eight minutes. I can walk to the bus station in about eight minutes. I can cook an egg in less than eight minutes. How about you?

A couple of months ago eight minutes changed for me. The agency I receive my treatment from and my doctor changed the way I see my doctor. Eight minutes became very valuable for me. And it’s all because of money and policies.

A couple of months ago I was informed I could no longer spend 15 to 30 minutes with my doctor. Now I would only have eight minutes!

Now a staff member takes me to an empty room and asks me questions from a paper. The questions are about smoking, drinking, sleeping. And what I want to talk with the doctor about. The staff member also writes my prescriptions for the doctor to sign while I see him.

Now I must narrow what I talk with the doctor about, be really focused. The eight minutes seem to be over before they start. I haven’t been able to get through my lists all the way yet except for last week.

All I can do is schedule appointments with the doctor more often if I don’t go over everything with him. This costs me more with my co-pay and Medicaid more.

I am seriously considering finding another agency for my treatment. Fifteen minutes would be better than eight!

Last week I met with my psychiatrist. He seemed to have a little more time than usual for the last couple of months. He stated he had been talking with my therapist. They were asking each other how they thought I am doing. The doctor stated they both thought I was a little better. He asked me why I thought this was. I suggested the skills sheet I fill out every night keeps me focused on using the skills.

He then went on to say they thought recently that I was going to jump off a bridge! He said this jokingly. However I feel it was not appropriate.

I became angry but said nothing. Lately I’ve not been too assertive, more passive, when I’ve met with doctors. I see my therapist this week so will bring up this incident with him.

My anger took a twist. I thought, “I’ll show you. I’ll go jump off a bridge!” Of course, I am not going to do this.

I am disappointed with my doctor. I have an appointment with him in a month. I may see if I can get an appointment sooner. Even if he was joking it was not appropriate.

Editor’s note: Indeed, it may take our assertions toward clinical and other provider folks to help re-define these relationships so that power and respect are more equally shared.

(Continued from Home page.) First of all, our Department of Health and Human Services and our Managed Care Organizations must consider what is at stake when administrators and providers do not respond to concerns in a timely way. Things just get worse. Period. Many of us liken this to watching a person who is having a personal difficulty as it quickly devolves into a serious crisis event because no one has responded at an earlier point with the appropriate action according to what the need is. In other words, our system tends to create crises when it does not respond in a timely way as transparently and as accountably as it can. This is, in part, why we are in the midst of this large system evolution–the crisis within our system that has spun out so many individual crises. Yet the only way having the new kind of care management is going to relieve our crisis is by focusing first on how it responds to those who must depend on it and their families.

A Request for LME/MCO staff: Please, at least call people back when they call you! Yes, we are hearing that LME staff are simply not following up with callers, even after they may have spoken. Even when you have to study a situation further or do not know how best to resolve it, please just be engaging and responsive to the person who is calling. Likely, the person is exhausted, in emotional turmoil, and is very aware of all that is at stake for himself or herself and close relationships when pieces of our system are not helpful. You cannot understand what a relief it is to be listened to, not just heard, with affirming statements identifying what you hear as problematic!

An engaged, considerate, and supportive voice on the other end of the line goes a long way to restore our faith in a process, and it gives us hope that there may indeed be a solution.

Now that so many are contacting our organization in moments of personal distress, NC CANSO wants to be confident that when we refer a person to a particular customer services staff within an LME, or to staff at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Servcies, or even to our protection and advocacy agency, Disability Right’s North Carolina, there will be a fully attentive, caring, and responsive individual empowering the caller with support, information, and some kind of action!

Please do your part to convey hope for us! We need this hope! And when hope is not a guiding value for system and provider behavior, the system itself can be more disabling to us than our problems.